With the University of California, Berkeley’s COVID-19 diagnostic lab up and running, University Health Services (UHS) is expanding its coronavirus testing for symptomatic students, aiming for a 24-hour turnaround that will allow medical staff to better manage patients and help them understand the extent of infection in the campus community.

“From a clinical perspective, any testing of infections like this that takes longer than a couple of days doesn’t help us as much, and the reality was that we were getting tests back six and seven days after testing. That is not clinically helpful,” said Dr. Guy Nicolette, assistant vice chancellor for UHS. “Knowing in a day or two, and hopefully within the same day, is amazing, because we then will be able to really limit the spread.”

Since April 6, when the Innovative Genomics Institute, an academic partnership between UC Berkeley and UC San Francisco, started testing nasal and oral swabs in its newly certified diagnostic lab, the Tang Center, UHS’s medical center, has sent approximately 50 patient samples, all of which so far have been returned negative within 24 to 36 hours. The center currently has the ability to obtain samples from as many as 100 people daily.

The Tang Center has also ordered kits to test for antibodies to the coronavirus that indicate whether a person has been exposed to the virus in the past. Called serology tests, they are typically performed on-site for more common college illnesses, such as mononucleosis, but also for more dangerous diseases, such as hepatitis and HIV. The coronavirus serology kits are expected to be available sometime next month.

“Serology can tell us if somebody has developed antibodies and whether they have less chance — I wouldn’t say no chance – of getting sick from this particular strain of virus,” Nicolette said. “It might also help us in returning health care staff back to work a bit more safely, for them and their patients.”

He cautioned that physicians still don’t know whether or how long people who recover from a COVID-19 infection retain long-lasting immunity to the coronavirus.

New testing criteria

Until now, because of the limited availability of COVID-19 test kits, the Tang Center has followed the evolving guidelines promulgated by the Centers for Disease Control and Prevention (CDC). That meant testing, in particular, those at high risk medically who had symptoms characteristic of COVID-19 — tiredness, fever, dry cough, difficulty breathing — or who had known exposure to someone who tested positive for COVID-19 or had recently visited China, Italy or other severely affected countries. Students were instructed to call the center’s triage nurses in advance, and if their symptoms matched the criteria, they were asked to drop in for a nasopharyngeal swab that was sent to a commercial lab. Results could take a week or longer.

Eva Linares, a medical assistant in primary care at the Tang Center, gives a worried student a description of the criteria for getting tested for COVID-19. (UC Berkeley photo by Brittany Hosea-Small)

After discussion with city and county public health officials, the center will now attempt to test all students with COVID-19 symptoms, whether or not they have a known exposure risk. Those with symptoms still must call in advance, but tents are set up on the Durant Avenue side of the Tang Center for drive-through or walk-through swabbing, after a phone consultation with a health care provider. (Read new testing guidelines) Testing is free for students no matter what their insurance plan.

The UHS also has the ability to test UC Berkeley’s essential employees — police officers and health care staff at UHS and the optometry clinics — but those employees are encouraged first to reach out to their primary health care providers and to alert the UHS’s Occupational Health program office if the medical assessment concurs with testing. If other campus employees have received testing results confirming positive COVID-19 infection at outside facilities, they are asked to alert Occupational Health (link to instructions), which is tracking cases of COVID-19 in the campus community. (UPDATE:As of late April 14, free testing is open to all UC Berkeley faculty and staff who are symptomatic and are working on campus to support essential functions.)

The good news is that, so far, testing has revealed few cases on campus. Only one of the nine currently confirmed COVID-19 cases among campus students, staff and faculty was discovered through Tang Center testing, and none of the infected appears to have circulated widely around the campus prior to diagnosis. All are recovering, and there are no reported deaths.

Nevertheless, Nicolette emphasized that the expanded diagnostic testing is an important tool to help manage the coronavirus epidemic and eventually to help inform the decision to relax campus shelter-in-place restrictions.

“The promise of expanded testing is that we then have a better understanding, in the real world, of who is infected and who isn’t,” he said. “Maybe we can help prevent clusters of infections from happening, and when somebody is ill, know best what to tell them to do. And patients will know quickly what is going on and be a bit more motivated to practice the physical distancing and isolation procedures necessary to prevent the spread. Paired with expanded contact tracing, this testing is a powerful way to mitigate the spread of COVID-19.”

The student health center has enough kits to swab 100 people daily, if necessary. The swabs are analyzed in a diagnostic lab recently opened on campus in the Innovative Genomics Institute. (UC Berkeley photo by Brittany Hosea-Small)